How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $48.98 Median $1,202.26 Typical High $7,585.78 | Facility | None | $48.98 | $1,202.26 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $173.78 | Professional | None | $35.48 | $75.86 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $3,311.31 Typical High $5,370.32 | Facility | None | $2,137.96 | $3,311.31 | $5,370.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $102.33 Typical High $208.93 | Professional | None | $41.69 | $102.33 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $39.81 Typical High $93.33 | Professional | None | $19.50 | $39.81 | $93.33 |
Denver HMP Setting Facility Modifier None Typical Low $33.11 Median $74.13 Typical High $144.54 | Facility | None | $33.11 | $74.13 | $144.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $37.15 Median $70.79 Typical High $177.83 | Professional | None | $37.15 | $70.79 | $177.83 |
Select Health Setting Facility Modifier None Typical Low $63.10 Median $107.15 Typical High $223.87 | Facility | None | $63.10 | $107.15 | $223.87 |
Select Health Setting Professional Modifier None Typical Low $21.88 Median $38.90 Typical High $107.15 | Professional | None | $21.88 | $38.90 | $107.15 |
United Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,905.46 | Facility | None | $239.88 | $616.60 | $1,905.46 |
United Setting Professional Modifier None Typical Low $25.70 Median $58.88 Typical High $100.00 | Professional | None | $25.70 | $58.88 | $100.00 |
3 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $61.66 Typical High $83.18 | Professional | 54 · Surgery only | $28.84 | $61.66 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $12.30 Typical High $16.60 | Professional | 55 · Aftercare only | $5.75 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $8.13 Typical High $11.22 | Professional | 56 · Pre-op care only | $3.80 | $8.13 | $11.22 |
Where Colorado sits
The same service costs 2.8 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 8th of 51
$100
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.